2007-03-27 04:00:00 PDT Sacramento -- Dan Hartmann, a 32-year-old Oakland graphic artist, met his wife Susan six years ago, and like many couples they decided they wanted to start a family.

There's a complication: A blood transfusion 20 years ago left Hartmann HIV-positive.

Medical technology has existed for more than a decade to "wash" the HIV from Hartmann's sperm, which then could be used to add a new member to the Hartmann household while mother and child remain HIV-free.

Except Hartmann can't get the treatment in California because the state bans the use of sperm from an HIV-positive donor.

"We want to have a kid, but the law here doesn't allow fertility clinics to help a man who is HIV-positive," Hartmann said.

Legislation will be debated Wednesday in the Senate Health Committee to permit the use of washed sperm from an HIV-positive donor to impregnate a consenting woman.

If signed into law, California would join 48 other states that allow the practice. Delaware is the other state that doesn't.

Because of the increase in life expectancy of people with HIV, more people who have the virus are considering starting a family. Supporters of the bill -- SB443 by Sen. Carole Migden, D-San Francisco -- say the measure helps ensure the rest of the family stays HIV-free.

"This isn't a gay issue. It's in society's interest to give these couples a safe method of reproduction," said Migden. "A clean procedure is available. Making it available in California is a positive step the government can take to produce healthy children."

HIV is present in seminal fluid and white blood cells but not in sperm. Through washing and the use of centrifugal force, sperm can be separated from the other components of semen and then injected into the woman's body or used for in vitro fertilization.

In studies issued over the past decade, some 4,500 fertilizations using treated HIV-positive sperm have been conducted worldwide without any infection of either mother or child, according to Dr. Deborah Cohan, an obstetrician and gynecologist at the University of California at San Francisco specializing in

HIV.

A survey conducted by Cohan of 67 California fertility centers logged 135 HIV-infected couples seeking help during the last year.

"That's the tip of the iceberg," Cohan said. "We don't even know how many people in California have HIV. We just started the process of collecting data last summer."

More than 80 percent of the clinics said they would provide services to HIV couples if the law were changed, Cohan said.

Without a change in law allowing HIV-positive men in California to use the sperm treatment, the only way they can impregnate their wife or partner is through unprotected sex, which can lead to transmission.

Cohan said one study found a 12 percent risk of male-to-female HIV transmission over a year of unprotected sex. Limiting unprotected sex to the period in which the woman is ovulating lowers the transmission rate to 4.3 percent but doesn't eliminate the possibility of infection.

"Timed, unprotected sex puts my wife at greater risk," said Hartmann.

Well-heeled couples can visit fertility centers outside California that offer the sperm treatment. That can be costly and time-consuming because more than one visit and, often, more than one attempt at fertilization are needed.

While the sperm washing is relatively cheap -- roughly $200 -- fertility treatments can be expensive. Uterine insemination, the so-called turkey-baster method, costs approximately $1,000, while in vitro fertilization, in which the egg is fertilized outside the body, can cost between $10,000 and $15,000, according to Migden's office.

"No fertility treatment is guaranteed to work especially the first time around," said Hartmann. "It's very expensive and a lot of time insurance doesn't cover it."

The treatment is available in most other states because their laws don't include a blanket prohibition on sperm donation from men with HIV. Under Migden's bill, the sperm washing would be done using procedures approved by the American Society of Reproductive Medicine.

California's ban stems from a 1989 California law aimed mainly at preventing what happened to Hartmann through blood transfusion from happening to others.

"No one would have thought in 1989 that people would be living so long with HIV or that we would have these techniques to wash HIV-positive semen so women could get pregnant and have healthy babies," Cohan said.

In 1997, exemptions were made to the sperm-donor category to allow sperm from men with syphilis, hepatitis B and hepatitis C. The lawmaker who carried that bill has since died, but Cohan said others involved in the bill's passage said HIV was not added to the list of exemptions for fear its inclusion would increase opposition to the legislation at the time.

"I'm hoping we've done sufficient education that people will realize this is good science and good public health, and it has nothing to with how someone got HIV," Cohan said. "It has everything to do with the rights of individuals with HIV and the partners of individuals with HIV."

There is no listed opposition to Migden's bill, and the measure has the tentative support of at least one Republican on the health committee

"There needs to be some stronger oversight built into the bill, but allowing an HIV-infected person to lead a normal life with their spouse and/or partner to procreate -- I'm absolutely for that," said Sen. Sam Aanestad, R- Grass Valley (Nevada County), vice chair of the panel. "Government should be in the business of encouraging those kinds of family decisions and make sure it's safe for everybody."